MedRophine Science

2022-05-31 16:16:03 Beautiful case of retroperitoneal schwannoma (CT and MRI features).
PS: the patient has also pancreatic head adenocarcinoma, check fusion T2/DWI باز کردن / نظر دهید

2022-05-30 19:15:07 Not all “scoliosis” is true scoliosis. When patients complain of sudden back and leg pain followed by twisting of the back, a disc herniation diagnosis has to be considered and treated first.

Postural (or reactive) scoliosis due to pain will likely resolve and not need major corrective surgery.

Yet another example why taking the time to listen to the patient (and not just focus on x-rays) is so important. باز کردن / نظر دهید

2022-05-30 16:04:03 Which of the following pulsed-wave (PW) Doppler spectral patterns would be least likely seen in a patient with chronic constrictive physiology?

A. Tricuspid valve inflow (Fig. A)
B. Mitral valve inflow (Fig. B)
C. LV outflow tract (Fig. C)
D. Descending abdominal aorta (Fig. D)
E. Distal right common carotid artery (Fig. E)
Answer: C. Images A, B, D, and E from the patient with chronic constrictive pericarditis (radiation therapy for lymphoma).Cardiac hemodynamics and their relationship to Doppler patterns in constrictive physiology are depicted in schematic Figure
Image A is a PW Doppler obtained from tricuspid valve inflow from a patient with constrictive pericarditis demonstrating >50% variation in tricuspid valve inflow E-wave with normal respiration. During inspiration, there is increase in the right-sided flow as evidenced by increase in velocity of the tricuspid inflow E-wave. باز کردن / نظر دهید

2022-05-29 10:10:28 This is a 29 year old, yes 29 year old that is 8 years post-op from a T2-L2 Fusion for Scheuermann’s Kyphosis (Hunched Back). He was 22 years old at the time of surgery. He was offered this procedure after failed PT. Preop films were not available. I question the move from PT to surgery without offering other options but we are where we are. Since this surgery he has been unable to work and now unemployed and doesn’t have insurance. He is of course dealing with incredibly horrible pain. He’s paying out of pocket. I’m going to offer a pain pump first to try to limit multiple procedures and hopefully get him back to work since he’s still in his 20’s! I’m posting this case because this is why Interventional Spine was born. باز کردن / نظر دهید

2022-05-28 07:19:35 Post-operative massive paraganglioma (glomus jugulare) mass of left side in a 50 years old woman presented with chief complaint of persistent pulsatile tinnitus and hearing loss of left ear. 24 hours before surgery the patient underwent an PVA angioembolization intervention for external carotid artery tumor-related branch and then Gd enhanced MRI was done (Fig. 1 blue arrow showing the prominent enlarged and tumor involved internal jugular vein).
During operation with Fisch (A) incision, exposure and double ligation of external carotid artery and internal jugular vein and radical mastoidectomy with preservation of facial nerve were done, and finally the highly bleeding tumor bulk from skull base (sigmoid sinus) to inferior border of level II internal jugular vein was resected (Fig. 2).
——————————————
Thanks to Dr. Ehsan Arjmandzadeh ( resident of otorhinolaryngology head and neck surgery at Tehran) to share this case whit us . باز کردن / نظر دهید

2022-05-28 07:11:30 This “monster” from yesterday presented one of the most challenging cases we face as a spine surgeons. This patient presented with rapidly progressive weakness in their lower extremities and were not able to walk over the past few hours. We made the decision to cancel our elective cases and put all of our best efforts towards assembling the A-team to tackle this “Monster” in less than 24 hours. The lateral retropleural mini open approach weaves together all the miscrosurgical skills from our skull base/vascular/cranial background and, with God’s help, the results for this patient were spectacular, both imaging-wise and clinically.
No CSF leak, No neurological deterioration, No chest tubes.
——————————————-
Thanks to Dr juan uribe ( Neurosurgeon) for share this case with us. باز کردن / نظر دهید

2022-05-24 10:45:22 The anterior retroperitoneal approach can be challenging (especially if you do not have access surgeons like most of us do not in Europe) but it is always gratifying for the patient. For isthmic spondylolisthesis I usually prefer ALIF combined with posterior percutaneous transpedicular screws.

This 56 years old lady with severe osteoporosis was suffering of excruciating low back pain and progressing bilateral radiating leg pain for years, while conservative treatment did not alleviate her symptoms.
I treated her with a two-level ALIF and she is doing great.

ALIF is a great MIS surgery. باز کردن / نظر دهید

2022-05-24 10:40:42 A great case to learn the difference between two very rare pathologies of the spinal vascular system. The case presented here, is a Cauda Equina Arterio-Venous Fistula (L2/L3 level). It needs to be differentiated from the Filum Terminale AVF.

Notice the transition from the ANTERIOR SPINAL to the RADICULAR ARTERY at the level of CONUS MEDULLARIS. This is the pathognomonic finding. Venous drainage shown in the lateral projection confirms this arrangement as well.

The article below is free-access and is pretty fantastic (Dr Komiyama is one of the authors, I recommend you to follow him on twitter for some fascinating cases). باز کردن / نظر دهید

2022-05-23 17:17:30 CT through the upper chest shows a large destructive mass arising from the sternum with a small amount of calcification most likely osteosarcoma, confirmed by biopsy. باز کردن / نظر دهید

2022-05-23 17:16:10 #Breast_cancer باز کردن / نظر دهید